• Milo Stanišić, John Hald, Inge Andre Rasmussen, Are Hugo Pripp, Jugoslav Ivanović, Frode Kolstad, Jarle Sundseth, Mark Züchner, and Karl-Fredrik Lindegaard.
• Department of Neurosurgery, Oslo University Hospital, Nydalen, Po. Box 4950, 0424, Oslo, Norway. mstanisi@ous-hf.no
• Acta Neurochir (Wien). 2013 Feb 1; 155 (2): 323-33; discussion 333.

BackgroundChronic subdural haematoma (CSDH) is a common entity in neurosurgery with a considerable postoperative recurrence rate. Computerised tomography (CT) scanning remains the most important diagnostic test for this disorder. The aim of this study was to characterise the relationship between the recurrence of CSDH after treatment with burr-hole irrigation and closed-system drainage technique and CT scan features of these lesions to assess whether CT findings can be used to predict recurrence.MethodsWe investigated preoperative and postoperative CT scan features and recurrence rate of 107 consecutive adult surgical cases of CSDH and assessed any relationship with univariate and multivariate regression analyses.ResultsSeventeen patients (15.9 %) experienced recurrence of CSDH. The preoperative haematoma volume, the isodense, hyperdense, laminar and separated CT densities and the residual total haematoma cavity volume on the 1st postoperative day after removal of the drainage were identified as radiological predictors of recurrence. If the preoperative haematoma volume was under 115 ml and the residual total haematoma cavity volume postoperatively was under 80 ml, the probability of no recurrence was very high (94.4 % and 97.4 % respectively).ConclusionsThese findings from CT imaging may help to identify patients at risk for postoperative recurrence.

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